None listed
Conditions
Brief summary
The provision of education, counselling and support directed at enhancing patient self-care skills is an important aspect in the longterm management of chronic heart failure (CHF). This study builds upon CIA Cameron's PhD program of research that identified factors that predicted CHF self-care [1-3]. The proposed study will evaluate a unique screening tool that complements the existing nursing assessment, helping to identify an individual’s level of CHF self-care ability according to three domains: physical, emotional and cognitive functioning, and patient clinical characteristics. The implementation of this screening tool will guide health care professionals in determining if the patient is at low, medium or high risk of inadequate CHF self-care, thereby permitting sophisticated monitoring and serving as a basis for developing individualised plans of care, including educational and behavioural strategies directed at promoting self-care. In this manner, tailoring education and follow-up strategies to individual need and ability may further enhance the clinical status of patients, ensuring that these vulnerable patients remain in their community for longer periods. The aim of this study is to evaluate the clinical application of the CHF self-care assessment tool. The research will be conducted at the Eastern Health sites that conduct a CHF management program (Box Hill, Maroondah and Angliss hospitals). Recruitment to the study will be conducted over a 16 month period. A research associate from Eastern Health’s Cardiology Research Department will recruit approximately 240 patients from the three CHF management programs within Eastern Health.
Interventions
The study intervention is the application of the screening tool by a CHF nurse clinician. The screening tool assesses physical, cognitive and emotional functioning as key determinants of CHF self-care. For each of the three domains the patient’s level of functioning is quantified as low, medium or high. In this manner, low functioning indicates the individual is at greater risk of inadequate self-care ability and will require more intensive strategies than an individual with high functioning. Th
The study intervention is the application of the screening tool by a CHF nurse clinician. The screening tool assesses physical, cognitive and emotional functioning as key determinants of CHF self-care. For each of the three domains the patient’s level of functioning is quantified as low, medium or high. In this manner, low functioning indicates the individual is at greater risk of inadequate self-care ability and will require more intensive strategies than an individual with high functioning. The screening tool is administered to each participant once only and is administered by the CHF nurse at their first home visit following recruitment to the study. The screening tool takes approximately10 minutes to administer. The screening tool provides the nurse clinician with recommendations on the frequency of contact, symptom monitoring and most appropriate educational and counselling approaches to adopt in promoting and supporting patient self-care. For example, if a patient is screened as ‘low’ self-care ability on the cognitive domain it is recommended that the CHF nurse has weekly contact with the patient via home visits or telephone support. The overall duration of the intervention is 3 months.
Sponsors
Cardiovascular Research Centre/ Australian Catholic University
Study design
Allocation
Randomised controlled trial
Intervention model
Other
Primary purpose
Educational / counselling / training
Masking
Blinded (masking used)
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
Participants will be 18 years of age or older and have a confirmed diagnosis of CHF. Confirmation of the diagnosis will be from: 1) symptoms and clinical features of congestion that occur at rest or on minimal effort (dyspnoea, orthopnea, paroxysmal nocturnal dyspnoea, fatigue, palpitations, elevated jugular venous pressure, cardiomegaly, lung crepitations, hepatomegaly, oedema); 2) either objective evidence of underlying structural cardiac dysfunction that impairs the ability of the ventricle to fill with or eject blood or an elevated plasma level of B-type natriuretic Peptide (BNP), >200 pg/mL. Participants will have been referred and enrolled into the CHFMP which is conducted across Eastern health.
Exclusion criteria
Patient participants will be excluded if they reside in a residential aged high care facility (nursing home), have a documented history of moderate-to-severe cognitive impairment or dementia, or have a terminal diagnosis. Participants who do not have sufficient comprehension to read English without the need of a translator will be excluded.
Outcome results
None listed